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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 561701471
Report Date: 09/13/2022
Date Signed: 09/13/2022 12:48:50 PM

Document Has Been Signed on 09/13/2022 12:48 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:OAK GROVE SCHOOLFACILITY NUMBER:
561701471
ADMINISTRATOR:LAURIE CORNELLFACILITY TYPE:
850
ADDRESS:220 WEST LOMITATELEPHONE:
(805) 646-8236
CITY:OJAISTATE: CAZIP CODE:
93023
CAPACITY: 52TOTAL ENROLLED CHILDREN: 52CENSUS: 20DATE:
09/13/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:12 AM
MET WITH:Laurie CornellTIME COMPLETED:
01:08 PM
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On September 13, 2022 @10:15 AM Licensing Program Analyst (LPA) Rona Chavez conducted an unannounced annual inspection at the above named facility. LPA met with Director Laurie Cornell and was provided a tour of the inside and outside of the center. There were 20 children in care with 5 staff providing care at the time of the inspection.

The center is located on the campus of Oak Grove School and uses one classroom. LPA observed required licensing documents mounted on a clip board at the entrance of the classroom. The facility has enough restrooms available for the children in care. LPAs did not observe any hazards/toxins items accessible to children. LPA observed working Carbon Monoxide Detector in the classroom. The classrooms has age appropriate toys and furniture readily accessible for children in care. The center does not provide meals or snacks for the children. Children bring lunches and snacks and water bottles from home. Lunches are labeled and stored in the children's cubbies. There is water stations available to refill the water bottles inside and outside. The outdoor playground has an ample amount of space for children to play. LPA observed the playground has age appropriate toys and structures available for children to use. The playground has ample amount of shade available.

Center uses hand written sign-in and sign-out logs. LPA viewed a current facility roster and was found complete. A sampling of children and staff records were reviewed and found to be complete. Teachers have required qualifications. Teachers present have current Pediatric First Aid/CPR certificates that expire on 10/07/2022. Teachers present have current AB 1207 Mandated Reporter Training certificates on file. LPA verified SB 792 Child Care Adult Immunization and Tuberculosis Requirements. Facility continues to follow COVID -19 guidelines. Facility participates in Emergency Drills with the school and the last Fire Drill was logged on 5/12/2022 and the last Earthquake Drill was on 6/2/2022.

Cont on 809-C
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Rona Chavez
LICENSING EVALUATOR SIGNATURE: DATE: 09/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/13/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: OAK GROVE SCHOOL
FACILITY NUMBER: 561701471
VISIT DATE: 09/13/2022
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Facility is not currently providing Incidental Medical Services.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Rona Chavez
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2022
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: OAK GROVE SCHOOL
FACILITY NUMBER: 561701471
VISIT DATE: 09/13/2022
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No deficiencies were cited during today's inspection.
.

Exit interview conducted and report was reviewed with the Director. Director was provided Appeal Rights.

A notice of site visit was given and must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Rona Chavez
LICENSING EVALUATOR SIGNATURE:

DATE: 09/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2022
LIC809 (FAS) - (06/04)
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